Using After Action Review to Identify Rapid Response Implementation Strategies for Emerging Drugs Among Youth

Drug use trends change rapidly among youth, leaving educators and researchers struggling to respond promptly. Widely adopted universal evidence-based interventions (EBIs), such as the Michigan Model for Health™ (MMH), and their delivery systems offer an opportunity to reach large youth populations and reduce the onset and escalation of emerging drug use trends. Tier 1 EBIs do not always reflect the most current needs of the context and population. Implementation strategies are needed to optimize EBIs and system responsiveness to emerging drugs. This study employs after action review (AAR) to examine past responses to emerging drugs and design implementation strategies for rapid responses. AAR centers on four key questions: (1) What was expected to happen? (2) What happened? (3) What went well? and (4) What can be improved? We collected qualitative data from 35 participants, including state education partners, school administrators, counselors, teachers, prevention specialists, and the state's health coordinator network. We used rapid qualitative and iterative inductive-deductive thematic analytic approaches. Data analysis revealed three central tenets for rapid responses: collaboration, readiness, and planning. We then identified implementation strategy core functions aligned with the central tenets and strategy form options (e.g., build/leverage a coalition) for each function to accommodate school-level heterogeneity. We created a systematic process to develop and deploy an implementation blueprint for building prevention infrastructure to enhance rapid responses for emerging drugs leveraging an existing intervention (MMH) and delivery system. AAR is a promising approach to identifying gaps and best practices in school-based responses to urgent drug crises. Our results indicate that while the core implementation strategy functions are constant, health coordinators benefit from strategy options tailored to their context. Trial registration: NCT05806840, https://classic.clinicaltrials.gov/ct2/show/NCT05806840 .